This paper looks at evidence from a systematic review undertaken for the National Institute of Clinical Excellence (NICE) in England and commissioned as a prelude to the issuing in 2008 of national public health guidance on mental health interventions at primary (elementary) school level (children aged four to 11 years). The review assessed all peerreviewed published material in the English language that met strict quality criteria. A relatively small proportion of this material emanated from the UK itself, but all the studies included have reasonably high relevance to the UK context. This review of targeted approaches looked at studies focused on remediating particular types of behaviour or working with particular groups of pupils, studies which addressed the factors likely to lead to poor mental health or mental disorders, and studies which included ways of identifying children at particular risk. The review provides evidence of the benefits of parental involvement in school-based attempts to respond to problems that emerge in children with a range of identified disorders. A reading of the literature involved also highlights, however, the large number of barriers and difficulties encountered in achieving full parent engagement, especially for children with serious behavioural problems.